Medically tailored meals for food insecurity and type 2 diabetes: Protocol for the Food as Medicine for Diabetes (FAME-D) trial

Berkowitz, Seth A.; Kruse, Gina; Ricks, Katharine A Ball; Burch, Jessica; Ouimet, Ethan; Kitzis, Beth; Forrest, Colleen; Terranova, Jean; Stewart, Paul W.; Buse, John B.; Keyserling, Thomas C.; Wexler, Deborah J.; Delahanty, Linda M.

doi:10.1016/j.cct.2022.107039

Cited by 4 publications

(1 citation statement)

References 65 publications

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“…A lack of representation of Hispanic or Latino participants and speci cally Spanish speakers has been identi ed as a major limitation of community nutrition interventions 1,32 and is speci cally highlighted as a major limitation of a large ongoing trial comparing medically tailored meals (a type of no-prep meal) and meal vouchers for people with food insecurity. 33 Understanding which interventions are most desirable and e cacious for racially and ethnically minoritized populations, is imperative given that 1) these populations are most impacted by diet-related disease and 2) research has shown diet quality may improve for non-Hispanic clients after visiting a food pantry, but may stay the same for Hispanic or Latino clients, which suggests visiting a food pantry alone may not be su cient to improve diet quality, 1,5 and that there may be disparities for Hispanic or Latino clients. 34 In our study we found that 47% of pantry clients did not have health insurance and 47% did not seek medical care at some point within the past two years due to concerns around cost.…”

Section: Strengthsmentioning

confidence: 99%

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients

Hollis-Hansen,

Haskins,

Turcios

et al. 2023

Preprint

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Background: Food pantry clients have high rates of food insecurity and greater risk for and prevalence of diet-related diseases. Many clients face time, resource, and physical constraints that limit their ability to prepare healthy meals using foods typically provided by pantries. We compared two novel approaches to alleviate those barriers and encourage healthier eating: meal kits, which bundle ingredients with a recipe on how to prepare a healthy meal, and nutritious no-prep meals, which can be eaten after thawing or microwaving. Methods: Participants were adult pantry clients from a large food pantry in the Southern sector of Dallas, Texas. We conducted a repeated measures between-subjects study with 70 clients randomized to receive 14-days of meal kits (n=35) or no-prep meals (n=35). Participants completed questionnaires at baseline and two-week follow-up on demographics, hedonic liking of study meals, perceived dietary quality, and food security. Two-way repeated measures analysis of variance was used to examine group and time effects, and group by time interactions. We also describe feasibility and satisfaction outcomes to inform future implementation. Results: Sixty-six participants completed the study (94%). Participants were predominantly Hispanic or Latino(a) (63%) and African American or Black (31%) women (90%). There was a significant interaction on hedonic liking of study meals (ηp²=0.16, F(1,64)=11.78, p<.001), such that participants that received meal kits had greater improvements in hedonic liking over time than participants in the no-prep group. We observed significant improvements in perceived dietary quality (ηp²=0.36, F(1,64)=36.38, p<.001) and food security (ηp²=0.36, F(1,64)=36.38, p<.001) across both groups over time, but no between group differences or significant interactions indicating one intervention was more effective than the other. Program satisfaction was high across both groups, but higher among the meal kit group (ηp²=0.09, F(1,64)=6.28, p=.015). Conclusions: Results suggest nutritious meal kits and no-prep meals may be desirable nutrition intervention strategies for pantry clients and have potential to increase food security and perceived dietary quality in the short-term. Our findings are limited by a small sample and short follow-up. Future studies should continue to test both interventions, and include longer follow-up, objective measures of dietary quality, and relevant clinical outcomes. Trial Registration: This trial was registered on 25/10/2022 on ClinicalTrials.gov, identifier: NCT05593510.

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Section: Strengthsmentioning

confidence: 99%

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients

Hollis-Hansen,

Haskins,

Turcios

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients

Hollis-Hansen,

Haskins,

Turcios

et al. 2023

BMC Public Health

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Background Food pantry clients have high rates of food insecurity and greater risk for and prevalence of diet-related diseases. Many clients face time, resource, and physical constraints that limit their ability to prepare healthy meals using foods typically provided by pantries. We compared two novel approaches to alleviate those barriers and encourage healthier eating: meal kits, which bundle ingredients with a recipe on how to prepare a healthy meal, and nutritious no-prep meals, which can be eaten after thawing or microwaving. Methods Participants were adult pantry clients from a large food pantry in the Southern sector of Dallas, Texas. We conducted a repeated measures between-subjects study with 70 clients randomized to receive 14-days of meal kits (n = 35) or no-prep meals (n = 35). Participants completed questionnaires at baseline and two-week follow-up on demographics, hedonic liking of study meals, perceived dietary quality, and food security. Two-way repeated measures analysis of variance was used to examine group and time effects, and group by time interactions. We also describe feasibility and satisfaction outcomes to inform future implementation. Results Sixty-six participants completed the study (94%). Participants were predominantly Hispanic or Latino(a) (63%) and African American or Black (31%) women (90%). There was a significant interaction on hedonic liking of study meals (ηp²=0.16, F(1,64) = 11.78, p < .001), such that participants that received meal kits had greater improvements in hedonic liking over time than participants in the no-prep group. We observed significant improvements in perceived dietary quality (ηp²=0.36, F(1,64) = 36.38, p < .001) and food security (ηp²=0.36, F(1,64) = 36.38, p < .001) across both groups over time, but no between group differences or significant interactions indicating one intervention was more effective than the other. Program satisfaction was high across both groups, but higher among the meal kit group (ηp²=0.09, F(1,64) = 6.28, p = .015). Conclusions Results suggest nutritious meal kits and no-prep meals may be desirable nutrition intervention strategies for pantry clients and have potential to increase food security and perceived dietary quality in the short-term. Our findings are limited by a small sample and short follow-up. Future studies should continue to test both interventions, and include longer follow-up, objective measures of dietary quality, and relevant clinical outcomes. Trial registration This trial was registered on 25/10/2022 on ClinicalTrials.gov, identifier: NCT05593510.

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Stakeholder Perspectives on the Acceptability, Design, and Integration of Produce Prescriptions for People with Type 2 Diabetes in Australia: A Formative Study

Law,

Trieu,

Madz

et al. 2024

IJERPH

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Produce prescription programs can benefit both individuals and health systems; however, best practices for integrating such programs into the Australian health system are yet unknown. This study explored stakeholders’ perspectives on the acceptability, potential design and integration of produce prescription programs for adults with type 2 diabetes in Australia. Purposive sampling was used to recruit 22 participants for an online workshop, representing six stakeholder groups (government, healthcare service, clinician, food retailer, consumer, non-government organisation). Participant responses were gathered through workshop discussions and a virtual collaboration tool (Mural). The workshop was video-recorded and transcribed verbatim, and thematic analysis was conducted using a deductive–inductive approach. Stakeholders recognised produce prescription as an acceptable intervention; however, they identified challenges to implementation related to contextuality, accessibility, and sustainability. Stakeholders were vocal about the approach (e.g., community-led) and infrastructure (e.g., screening tools) needed to support program design and implementation but expressed diverse views about potential funding models, indicating a need for further investigation. Aligning evaluation outcomes with existing measures in local, State and Federal initiatives was recommended, and entry points for integration were identified within and outside of the Australian health sector. Our findings provide clear considerations for future produce prescription interventions for people with type 2 diabetes.

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Medically tailored meals for food insecurity and type 2 diabetes: Protocol for the Food as Medicine for Diabetes (FAME-D) trial

Cited by 4 publications

References 65 publications

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients

A pilot randomized controlled trial comparing nutritious meal kits and no-prep meals to improve food security and diet quality among food pantry clients

Stakeholder Perspectives on the Acceptability, Design, and Integration of Produce Prescriptions for People with Type 2 Diabetes in Australia: A Formative Study

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